Claim processor jobs in Sterling Heights, MI

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description: Are you an experienced Claims Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: • Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments • Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error • Identifies potential Provider problems through a proactive approach in which data is mined and trended to identify and prevent provider problem areas Qualifications Hours for this Position: • Mon-Fri 8am-4:30pm Advantages of this Opportunity: • Competitive salary, negotiable based on relevant experience • Acquire new skills and learn new knowledge • Fun and positive work environment Qualifications/ Requirements: • Must be bilingual in Spanish • Claims, Appeals, Denials experience for an insurance company or hospital or medical office or financial company • HS Diploma/GED Additional Information Interested in hearing more about this great opportunity? If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Job Title: Claims Examiner FLSA Status: Non-Exempt Department: Claims Reports to : Claims Manager Proctor Loan Protector does not sponsor any type of work visa's or STEM programs. Who are we? What do we do? Company Overview: Proctor Loan Protector provides comprehensive insurance products and service solutions for financial institutions. While weaving compliance throughout all our applications and technologies, Proctor Loan Protector operates as an extension of our clients, where partnership meets innovation. What's the culture like at Proctor Loan Protector? At Proctor Loan Protector, we are committed to fostering a workplace that values diversity and personal growth. As we continue to grow and expand, this allows us to offer career paths and opportunities. We are dedicated to ensuring that all our teammates feel valued and work in a fun and rewarding work environment. What can I expect from working at Proctor Loan Protector? Fun work environment with a variety of work Being part of a team Career growth Ability to highlight your skills Feel valued Great benefits, pay and culture Tell me more about this role, what would I be doing? Summary: This position is responsible for reviewing Property Claims to meet internal and statutory compliance requirements concerning timely and accurate review, best practices, documentation, adjustment and indemnity approval of assigned property claims. For liability claims, the position is responsible for coordinating with the carrier and assigned adjusting firms. Essential Duties and Functions: include the following. Other duties may be assigned. Review documents, estimates, policy forms, and determine if and how coverage applies to submitted claims; Authorize payment within scope of authority, effectively resolving claims in a cost-effective manner and ensuring timely issuance of disbursements; referrals to carriers as needed; Write coverage letters detailing coverage positions Interact professionally with insurance carriers, internal and external customers and departmental staff. Competencies: Planning/organizing-the individual prioritizes and plans work activities and uses time efficiently. Interpersonal skills-the individual maintains confidentiality, remains open to ideas and exhibits willingness to try new things. Oral communication-the individual speaks clearly and persuasively in positive and negative situations and demonstrates group presentation skills. Written communication-the individual edits work for spelling and grammar, presents numerical data effectively and is able to read and interpret written information. Problem solving-the individual identifies and resolves problems in a timely manner, gathers and analyzes information skillfully and maintains confidentiality. Quality control-the individual demonstrates accuracy and monitors own work to ensure quality. Adaptability-the individual adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events. Safety and security-the individual observes safety and security procedures and uses equipment and materials properly. Confidentiality - Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Required: High School Diploma/GED 2-4 years of experience in the field or property insurance/adjusting experience Must hold active Adjuster license(s) Proficient with MS Office - specifically Word, Excel, and Outlook Estimating software experience Strong customer service skills Strong attention to detail Excellent written & verbal communication skills Ability to maintain an acceptable volume of work production, Excel in a team environment- internal and external Exceptional telephone demeanor Ability to maintain a high level of confidentiality Preferred: Associate's or Bachelors' degree in a business or financial related discipline Inside Adjuster Experience/Background Adjuster license in home state. Physical Requirements Necessary on a Regular Basis: Repetitive motion. Manual dexterity, arm and upper body range of motion sufficient for use of a keyboard, mouse and telephone 7-8 hours per day. Speech and hearing sufficient for in-person and telephone communication 7-8 hours per day. Vision sufficient for use of a computer monitor. Sedentary position. Ability to sit at a desk 7-8 hours per day. Worker not substantially exposed to adverse environmental conditions Pay Ranges: Any posted pay range considers a wide range of compensation factors, including skills, experience, work location and more. We offer competitive pay while still allowing for compensation growth within the position and company. This job description is not meant to be an all-inclusive statement of the duties of the position listed above. Other appropriate duties may be required from time to time. EEO Statement: The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. Proctor Loan Protector provides equal employment opportunities (EEO) to all employees and applicants including Veterans and those with disabilities. Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************

The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. Follow claims handling procedures and participate in claim negotiations and settlements. Deliver a high level of customer service to our agents, insureds, and others. Devise alternative approaches to provide appropriate service, dependent upon the circumstances. Meet with people involved with claims, sometimes outside of our office environment. Handle investigations by telephone, email, mail, and on-site investigations. Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. Assist in the evaluation and selection of outside counsel. Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience A minimum of three years of insurance claims related experience. The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. The ability to effectively understand, interpret and communicate policy language. The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. *Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Supplier Claims Auditor Hybrid | Warren, MI Part-Time | Hours Assigned as Needed Hours of Operation: Monday- Friday, 7:00 AM - 4:00 PM EST About the Role: As a Supplier Claims Auditor, you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier obsolescence and cancellation claims. You'll validate costs, ensure compliance with contract terms and conditions, and prepare detailed audit reports for internal and external stakeholders. This position requires strong analytical, financial, and organizational skills, along with a proactive approach to problem-solving and collaboration. A typical day includes reviewing assigned supplier claims, auditing supporting documentation, preparing audit files and recommendations, collaborating with internal stakeholders to determine settlements, and tracking open claims to ensure timely resolution. This position is ideal for someone who enjoys detail-oriented, analytical work and thrives in a collaborative yet independent environment. Requirements: We're looking for professionals who are analytical, organized, and comfortable managing multiple priorities. To be successful in this role, you should have: * Experience in auditing, finance, purchasing, tax, or cost analysis * Proficiency in Microsoft Excel, including PivotTables, VLOOKUP, and Conditional Formatting * Strong written, verbal, and interpersonal communication skills * Ability to manage multiple claim reviews and meet deadlines independently * Familiarity with automotive manufacturing processes and cost factors such as labor, materials, and profit * Successful completion of background check Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $ 45,360 - $ 56,700. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to ********************. You may also click here to access Conduent's ADAAA Accommodation Policy.

... The Workers' Compensation Claim Supervisor, working under general direction, is responsible for supporting the administration of workers' compensation policies and procedures related to claim filing, claim fulfillment, incident investigations, etc., with fairness and consistency in a timely manner. Additionally, the role is responsible for staying updated on trends and industry practices within the workers' compensation domain, collaborating with teams to implement training programs, and ensuring compliance with policies. The role would also maintain accurate and confidential records and data related to workers' compensation matters. You'll have... Bachelor's Degree in Human Resources, Risk Management, or any other related discipline or commensurate work experience in workers' compensation. Minimum 7 years of experience managing multi-state workers' compensation claims and navigating diverse regulatory environments. Work Requirements… Involves frequent (defined as one to two-thirds of the time) lifting of more than 10 to 25 pounds. Work performed requires a good deal of walking or standing and may include some sedentary work and working conditions that include moderate noise levels related to the use of office equipment or machinery. May involve exposure to varying outside temperatures. This description outlines the general nature and scope of work typically performed in this job. It is not intended to be an exhaustive list of all duties, responsibilities, knowledge, skills, work requirements, etc. It may vary slightly based on business or geographic needs and is subject to being reviewed and updated periodically. You may not check every box, or your experience may look a little different from what we've outlined, but if you think you can bring value to Ford Motor Company, we encourage you to apply! As an established global company, we offer the benefit of choice. You can choose what your Ford future will look like: will your story span the globe, or keep you close to home? Will your career be a deep dive into what you love, or a series of new teams and new skills? Will you be a leader, a changemaker, a technical expert, a culture builder…or all the above? No matter what you choose, we offer a work life that works for you, including: Immediate medical, dental, vision and prescription drug coverage Flexible family care days, paid parental leave, new parent ramp-up programs, subsidized back-up childcare and more Family building benefits including adoption and surrogacy expense reimbursement, fertility treatments, and more Vehicle discount program for employees and family members and management leases Tuition assistance Established and active employee resource groups Paid time off for individual and team community service A generous schedule of paid holidays, including the week between Christmas and New Year's Day Paid time off and the option to purchase additional vacation time. This position is a salary grade 7. For more information on salary and benefits, click here: New Hire Benefits Visa sponsorship is not available for this position. Candidates for positions with Ford Motor Company must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. In the United States, if you need a reasonable accommodation for the online application process due to a disability, please call **************. This position is hybrid (onsite four days per week) for candidates who are in commuting distance to a Ford hub location. #LI-Hybrid #LI-LP3 What you'll do... Implements the execution of the organization's workers' compensation policies and procedures, with fairness and consistency in a timely manner. Ensures compliance with employment laws, regulations, and company policies. Offers expert technical and jurisdictional guidance to claim staff regarding complex compensability, investigation and litigation issues. Supports handling the workers' compensation claims from initial report to resolution and investigates accidents involving company staff, vehicles, and equipment. Performs regular workers' compensation operations review with each plant location to ensure each case has an action plan in place. Ensures necessary documentation is obtained and provided to the claim adjusters. Determines the need to report claims and maintains regular communication/review with claim adjusters to ensure excellent management of claims. Represents the company at workers' compensation claim review meetings as required. Coordinates modified duty return-to-work efforts with the claim adjusters, HR, and plant operations. Participates in the delivery of workers' compensation special projects by representing the team as the prime contact, coordinating with senior internal and industry personnel, integrating data and information from multiple sources to identify trends, and innovating solutions to minimize the overall cost of workers' compensation claims through effective claims management and loss prevention strategies. Stays updated on workers' compensation laws and regulations to ensure program compliance. Monitors claims status, maintains files, and provides necessary support in defense of claims. May maintain occupational safety and health agency records if necessary. Supports the preparation of regular reports on workers' compensation program performance, trends, and metrics for management. Compiles and analyzes data related to workplace injuries, claims, and costs. Maintains important records related to claim processing such as medical bills, treatment plans, etc. Provides input on risk assessments, development of strategies, action plans, and associated recommendations to move claims to settlement or closure. Participates in the annual audit process for the company's workers' compensation programs including claims administration, cost analysis, injured employee communications, and return-to-work programs, and updates existing policies related to the workers' compensation function, whilst maintaining compliance and consistency with relevant laws and companywide policies. Supports the development of trainings to educate employees about the workers' compensation processes, their rights, and responsibilities. Demonstrates full knowledge of industry best practices in workers' compensation subjects such as loss prevention and rehabilitation management programs along with a strong understanding and application of related concepts and principles. Attends conferences, and other trainings to stay current on risk, claims, and safety developments. Coaches and guides managers and employees on matters related to workers' compensation.

Job DescriptionBenefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance Who We Are Incingo is a medical cost containment company that helps manage everything from short-term post-op to catastrophic care for workers compensation claims. We use our nationwide network of proven, credentialed vendors and create customized programs for efficient authorizing and shipping of medical supplies. We also coordinate medical transportation, home health care and in-home modifications. We are located in the heart of downtown Ann Arbor and we are looking for a full-time Claims Specialist. Hybrid work is available, prefer candidates in Michigan. We offer a best-in-class benefits package with a flexible work environment. Our culture is one of caring and collaboration, and we enjoy a team-oriented environment. Visit our website or LinkedIn to learn more. What Youll Do Serve as primary contact for inbound and outbound customer support by phone, email, or instant message Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms. Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations Review EOBs and address denial and partial payment of invoices in a timely and accurate manner Maintain accurate documentation of workers compensation claim files in multiple databases Ensure quality components of service delivery and patient/payor satisfaction with services provided Establish and maintain strong vendor relationships Participate in process for continuous credentialing and quality monitoring of assigned accounts Work with team to conduct cost analysis and identify margin opportunities Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation What Youll Bring High School Diploma (or equivalent); college degree preferred 1+ year experience in a medical setting preferred A customer focused approach to tasks and responsibilities Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day Intermediate MS Suite, typing and email skills Excellent verbal and written communication skills Familiarity of workers compensation state fee schedules preferred Flexible work from home options available.

Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )

Medicaid Specialist at Cambridge Dental Group - Dearborn Heights, MI* Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency. Responsibilities: Submit all Medicaid pre-authorizations and claims in a timely manner. Follow up consistently on pre-authorizations and claims to ensure proper resolution. Review and manage daily work logs to resolve outstanding claims. Appropriately document all account activities within the practice management system. Process EOB and R/A payments/denials accurately and promptly. Communicate effectively with leadership, co-workers, and dental offices regarding claim status. Maintain a high level of accuracy and attention to detail in all job functions. Provide backup support to other CBO team members as needed. Required Qualifications: 5+ years of Medicaid billing and RCM experience (preferred) Proven ability to manage pre-authorizations and claims efficiently High attention to detail and task-focused work style Strong organizational and follow-up skills Preferred Qualifications: Some dental clinical experience (helpful but not required) Why Join Us: Full-time position with comprehensive benefits including health insurance, life insurance, PTO, paid holidays, disability options, 401k with match Be part of a supportive and collaborative CBO team Play a key role in ensuring smooth financial operations for our office Competitive compensation and growth opportunities within a trusted dental group #indeedwavedp Requirements Education and Training High school diploma or equivalent required. Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years. Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required. Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred. FLSA Status: Hourly, Non-Exempt Reports to: VP of Finance

Job Description About Us PACE Southeast Michigan is a unique health plan and comprehensive care provider, committed to keeping chronically ill aging adults in their home, by caring for their medical, psychosocial and spiritual needs. Join a mission-driven team that's changing lives every day - helping seniors age with dignity, purpose, and joy. About the Role Under the supervision of the Finance Manager, the PACE Southeast Michigan (PACE SEMI) Claims Specialist is responsible for performing a variety of functions related to processing and analyzing medical claims. Primary Functions: • Process all medical claims according to vendor contracts, Medicare/Medicaid guidelines, and internal authorizations. • Manage the collection and submission of risk adjustment and encounter data to Medicare. • Analyze, maintain, and update computer programs to provide accurate financial data to various departments. • Keep abreast of governmental regulations pertaining to Medicare/Medicaid reimbursement. • Perform other duties as assigned. Knowledge, Skills, and Abilities: • Bachelor's degree in healthcare administration. • In lieu of degree, 3-5 years of medical claims processing experience will be considered. • Basic knowledge of computer programming to learn PACE SEMI's financial system and understand complex governmental regulations. • Visual ability required for analyzing reports, contracts, and other documents. • Manual dexterity requires preparing and tabulating data and drafting reports • Must meet or exceed core customer service responsibilities, standards, and behaviors, including: o Communication o Ownership o Confidentiality o Understanding o Motivation o Sensitivity o Excellence o Teamwork o Respect • Self-directed, flexible, and committed to the team concept. • Demonstrated teamwork, initiative, and willingness to learn. • Maintains customer service skills as provided through ongoing training and in-services. • Completes all annual mandatory in-service trainings and screenings, including but not limited to infection control, TB testing, flu shot, emergency preparedness, HIPAA, ergonomics, and participant rights. • Possesses the ability to establish and maintain effective interpersonal relationships. Working Conditions: • Office setting with possible local travel to other PACE centers. • Normal office environment with minimal exposure to noise, dust, or extreme temperatures.

The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west).

Job Details CLEMENS COURT APTS - Clinton Twp, MI Full Time DayDescription Independent Management Services is a full-service property management and marketing firm, specializing in the revitalization of under-managed multifamily housing developments. Since our founding in 1989, we have expanded our nationwide presence to include over 100 sustainable communities in 11 states focusing exclusively in the affordable and workforce housing sectors. However, our total breath of experience also includes market rate and commercial property management. We offer competitive salaries commensurate with experience and a comprehensive benefit package. We intend to build a team of individuals, who are self-motivated, willing to learn and grow with our firm. We progressively uphold a professional management team to serve our clients, enhancing our management skills and capabilities. Your progress, training, experience, motivation, attitude, and goals may create many possibilities for career opportunities with our company. If you have superior attention to detail with outstanding communications skills and enjoy a challenging fast pace environment, join our team now! Responsibilities: Occupancy, marketing, leasing, and resident verification procedures. Collect information from residents for eligibility screening, rent calculation, and income verification. Initial and annual recertification of income for residents. Complete unit inspections prior to move in/out and ensure units are ready for occupancy within deadlines. Receive and resolve resident requests and concerns. Foster positive working relationships with residents while always maintaining a professional demeanor. Administrative support tasks such as filing, typing, answering telephones, and data entry. Reports directly to the Site Manager. Job Qualifications: Sales-minded individual with attention to detail and strong verbal/written communication skills. Excellent follow-up skills via telephone or email correspondence. Experience with Tax Credit Compliance, EIV, and HUD Section 8 subsidy programs. Knowledge of REAC and MOR compliance. Proficiency with Paycom software and Microsoft Office suite preferred. Experience with RealPage OneSite preferred. Demonstrated track record regarding work attendance and reporting to work timely. Must adhere to Federal Fair Housing Laws. Qualifications We offer a competitive salary plus benefits including: Employer paid health and dental insurance (100% employee only) with affordable dependent and family coverage. Voluntary insurance options: Vision, Life, Accident Injury, Long-Term Disability, and Identity Theft. 401(k) with above-average employer matching contribution. Generous paid time off package. Training and employee development program. Among many other employee benefits.

The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west).

Since 2002, Quantix ProTech has successfully delivered IT resources and solutions to companies while building a solid reputation for integrity and consistent quality. Quantix ProTech continues to partner with the commercial sector for specialized IT placement and staffing services. Quantix ProTech was recently featured in US News and World Report and Forbes. Job Title: Healthcare Claims Auditor Location: Ann Arbor, MI Type: Contract Length: Through 12/22/2016 Job Description: Our client in the Ann Arbor, Michigan area is looking for Healthcare Claims Auditors to join their team on a short term contract basis. This candidates will translate client's healthcare Summary Plan Descriptions into plan builds in the the audit rules engine. Successful candidates will have a solid understanding of healthcare claims processing having gained experience working for a health plan or a TPA. Required Skills: 1) Healthcare Claims Auditing. 2) Helathcare Coding methods. Qualifications Required Skills: 1) Healthcare Claims Auditing. 2) Helathcare Coding methods. Additional Information All your information will be kept confidential according to EEO guidelines. If your interested, send a copy of your resume at henriquez@quantixinc. com or reach me at ************.

The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job. • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor** **Hybrid | Warren, MI** **Part-Time | Hours Assigned as Needed** **Hours of Operation: Monday- Friday, 7:00 AM - 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor, you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier obsolescence and cancellation claims. You'll validate costs, ensure compliance with contract terms and conditions, and prepare detailed audit reports for internal and external stakeholders. This position requires strong analytical, financial, and organizational skills, along with a proactive approach to problem-solving and collaboration. A typical day includes reviewing assigned supplier claims, auditing supporting documentation, preparing audit files and recommendations, collaborating with internal stakeholders to determine settlements, and tracking open claims to ensure timely resolution. This position is ideal for someone who enjoys detail-oriented, analytical work and thrives in a collaborative yet independent environment. **Requirements:** We're looking for professionals who are analytical, organized, and comfortable managing multiple priorities. To be successful in this role, you should have: + Experience in auditing, finance, purchasing, tax, or cost analysis + Proficiency in Microsoft Excel, including PivotTables, VLOOKUP, and Conditional Formatting + Strong written, verbal, and interpersonal communication skills + Ability to manage multiple claim reviews and meet deadlines independently + Familiarity with automotive manufacturing processes and cost factors such as labor, materials, and profit + Successful completion of background check _Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $_ _45,360 - $_ _56,700._ Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form (********************************************************************************************** . Complete the form and then email it as an attachment to ******************** . You may also click here to access Conduent's ADAAA Accommodation Policy (***************************************************************************************** .

The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. EDUCATION / EXPERIENCE REQUIREMENTS • Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job. • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance Who We AreIncingo is a medical cost containment company that helps manage everything from short-term post-op to catastrophic care for worker's compensation claims. We use our nationwide network of proven, credentialed vendors and create customized programs for efficient authorizing and shipping of medical supplies. We also coordinate medical transportation, home health care and in-home modifications. We are located in the heart of downtown Ann Arbor and we are looking for a full-time Claims Specialist. Hybrid work is available, prefer candidates in Michigan. We offer a best-in-class benefits package with a flexible work environment. Our culture is one of caring and collaboration, and we enjoy a team-oriented environment. Visit our website or LinkedIn to learn more. What You'll Do Serve as primary contact for inbound and outbound customer support by phone, email, or instant message Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms. Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations Review EOB's and address denial and partial payment of invoices in a timely and accurate manner Maintain accurate documentation of workers compensation claim files in multiple databases Ensure quality components of service delivery and patient/payor satisfaction with services provided Establish and maintain strong vendor relationships Participate in process for continuous credentialing and quality monitoring of assigned accounts Work with team to conduct cost analysis and identify margin opportunities Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation What You'll Bring High School Diploma (or equivalent); college degree preferred 1+ year experience in a medical setting preferred A customer focused approach to tasks and responsibilities Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day Intermediate MS Suite, typing and email skills Excellent verbal and written communication skills Familiarity of workers compensation state fee schedules preferred Flexible work from home options available. Compensation: $45,000.00 - $50,000.00 per year We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Physician Dispensing providers are proliferating. But WRS is one of the few that's trusted over time, with 12+ years in orthopedic healing. We know what works. And we understand that even the simplest change is tough in a busy practice. So our local support is there 24/7, to help integrate your dispensing program into your day-to-day workflow, seamlessly. Immediate dispensing can make all the difference. Our non-opioid formulary and multidisciplinary approach to healing can help manage patient's pain through non-narcotic alternatives. Ready access to treatment helps to save you time and saves patients added pain, as post-op treatment regimens begin faster. So patients may return to work faster, too. Along with our on-call pharmacist support for any questions that arise, together, we can fight today's opioid epidemic.